§ 97-25.4. Utilization guidelines for medical treatment. - North Carolina Statutes

§97‑25.4.  Utilization guidelines for medical treatment.

(a)        The Commission mayadopt utilization rules and guidelines, consistent with this Article, formedical care and medical rehabilitation services, other than those servicesprovided by managed care organizations pursuant to G.S. 97‑25.2,including, but not limited to, necessary palliative care, physical therapytreatment, psychological therapy, chiropractic services, medical rehabilitationservices, and attendant care. The Commission's rules and guidelines shallensure that injured employees are provided the services and care intended bythis Article and that medical costs are adequately contained. In developing therules and guidelines, the Commission may consider, among other factors, thepractice guidelines adopted by the boards and associations representing medicaland rehabilitation professionals.

(b)        Palliative carerules or guidelines adopted by the Commission may require that the provider (i)supply to the employer a treatment plan, including a schedule of measurableobjectives, a projected termination date for treatment, and an estimated costof services, and (ii) obtain preauthorization from the employer, notinconsistent with the provisions of G.S. 97‑25.3. (1993(Reg. Sess., 1994), c. 679, s. 2.4.)